care design

Origins of Care Design 2016

In the first of our blog posts, Helen Bevan tells us about the thinking and motivation behind the origins of Care Design 2016.

2015 is the 10th anniversary of a report that Nigel Edwards (CEO, Nuffield Trust) and I wrote on “design principles” as a collaboration between the NHS Modernisation Agency and the NHS Confederation. Even a decade ago, in a pre-digital age, this report was downloaded tens of thousands of times and was one of the most popular Confed reports of the 2000s. So we decided to repeat this activity in 2015, but using modern methods for engagement and collaboration.

The starting point of our 2015 effort was a presentation that Nigel Edwards made to the staff meeting of NHS England last year titled “Creating new care models in the NHS: some lessons and ideas”. As Nigel said in his presentation, “We cannot specify exactly what a service model should be like (context, starting points, what is available, etc.) but we can isolate the principles that create success because- ‘every system is perfectly designed to get the results it gets’”. In this talk, Nigel identified some underpinning redesign themes in new care models.

So we started to look across the globe at the system redesign principles underpinning new care models. Everywhere we looked, from ACOs (Accountable Care Organisations) in the USA, to integrated care in Canterbury New Zealand, to the radical pathway redesign currently happening in Jönköping, Sweden, we saw recurring themes in the principles upon which care systems were being designed. So we decided to seek to distil this experience and convey this expert insight and knowledge to people who were at an earlier stage of system redesign as our 2015 “design principles” offer.

Our project aims to capture and synthesise these system redesign principles, identify examples of these principles in action and signpost people to tools, methods and resources that can help in the implementation of the redesign principles. History tells us that the use of well-established design principles increases the chance that a change process will be successful. We can use these system redesign principles as a resource to increase knowledge and understanding of the design issues, bring together ideas, and provide a more confident starting point for change. It fits with the “replication” theme of the new care models strategy and will hopefully help with spread.

We have set up this crowdsourcing platform so that we can involve thousands of people in this project. Where we have done this previously, around 75% of the input comes from NHS colleagues but we get engagement from many countries. We want to create the system redesign principles by unlocking the collective wisdom and experience of people who use and work in the health and care system. The approach is being overseen by a diverse “expert group” from around the globe. This includes some “hidden gem” NHS medics (who are trained as clinical systems engineers and have a huge amount of expertise on patient flow), academics and practitioners. We have invited some people with specialist expertise from vanguard and ICP (Integrated Care Programme) localities. The role of the expert group is to help identify, challenge and sense-check the principles as they are developed over the next four months.

The five aims of Care Design 2016 are to:

Distil a set of principles for system redesign that is globally applicable

Organise the principles in a way that makes them accessible and highly usable to people designing new systems for delivering care

Identify examples from across the world of the system redesign principles in action

Signpost tools, methods and resources that can help in the implementation of the redesign principles;

Demonstrate the power of design thinking for health and care transformation.

Over the next four months, we will:

Test, challenge, adapt and validate the core system redesign principles;
Identify methods and resources to support implementation of the principles;
Capture examples of the system redesign principles in action;
Encourage people to build the redesign principles into their change efforts and build capabilities in the methods underpinning the principles.

We anticipate that there will be a huge amount of interest in the outputs of our project from around the world, so I encourage you to get involved, share your wisdom and experience generously and help us create a thriving community of people that want to make positive changes for the future in health and care.

You can find out more about this project and get involved now!

Helen Bevan
Chief Transformation Officer
Horizons NHS England